Monkeypox is a rare viral disease not often seen in the United States. Anyone can get monkeypox. Most people recover in 2–4 weeks, but the disease can be serious, especially for children and people who are immune compromised or pregnant. For more general information, see our monkeypox page.
Immediately report suspected monkeypox cases.
Call (253) 649-1412. We will help you fill out an intake form and review exposure guidelines to evaluate close contacts.
Stay updated.
Sign up for email alerts and choose “Health Advisories and Disease Alerts.”
View our monkeypox fact sheet for healthcare providers for how to identify, protect against, test, treat and report.
How to identify
It can be easy to miss monkeypox or mistake it for herpes, syphilis, folliculitis or an abscess.
Early symptoms
- Fever.
- Malaise.
- Headache.
- Weakness.
- Swollen lymph nodes.
Lesions
- Are well circumscribed, deep seated and often develop umbilication (dot on the top of the lesion).
- Can be extremely painful.
- Appear after fever.
Lesions tend to appear and develop at the same time on an affected area of the body—like pustules on face or vesicles on legs. They progress through 4 stages—macular, papular, vesicular and pustular—before they scab and heal in 1–2 weeks.
Transmission
Monkeypox mostly spreads through close, physical contact, and is far less likely to be spread in the air.
The virus spreads through contact with:
- Monkeypox rash, sores or scabs.
- Objects, fabrics or surfaces a person with monkeypox used.
- Respiratory droplets or oral fluids from a person with monkeypox.
Monkeypox can spread as soon as symptoms start until all sores heal and a fresh layer of skin forms. This can be several weeks.
Personal protective equipment (PPE)
When you interact with a patient, wear:
- Gown.
- Eye protection (i.e., goggles or a face shield that covers the front and sides of the face).
- Gloves.
- NIOSH-approved particulate respirator equipped with N95 filters or higher.
How to test
Use a PCR test to collect a sample.
- Collect 2 swabs from each lesion on 2 separate sites. Use synthetic swabs (i.e., Dacron, polyester, nylon). Do not use cotton swabs. Vigorously swab lesions. You don’t need to de-roof the lesion before swabbing.
- Break off the end of each swab’s applicator into separate screw-capped tube or place swabs in separate sterile containers or viral transport medium (VTM). Do not use universal or other transport media.
- Store samples at 2–8° C within an hour of collection. If the testing lab won’t receive the sample within 24 hours, freeze it. Coordinate a plan with your lab manager.
Submit to a lab.
Ask your lab if they test for monkeypox. Follow the lab’s sample collection procedure. Labs that currently test for monkeypox:
Washington has no shortage of monkeypox tests.
How to treat
Use tecovirimat (TPOXX) antiviral medication to treat people who are at high risk of severe disease. Lean more in Centers for Disease Control and Prevention’s (CDC’s) interim clinical guidance. To start the order process, call us at (253) 649-1412.
Vaccine
Demand for MPV vaccine is high and the supply from CDC remains limited.
We are working with pharmacies, healthcare providers and community partners who routinely provide care to people at high risk of exposure to get MPV vaccine to those who need it most.
If you have questions about treatment or vaccine, contact us at MPVClinical@tpchd.org.
Resources
For clinicians
- Monkeypox page, Washington State Department of Health (DOH).
- Monkeypox page for healthcare professionals, CDC.
- Clinician frequently asked questions, CDC.
- Clinical recognition of monkeypox, CDC.
- Ordering and using TPOXX, CDC.
- PCR diagnostic protocol, CDC.
- Diagnostic process for testing, CDC.
- Infection prevention in healthcare settings, CDC.
- Virtual grand rounds: Updates in COVID-19 and monkeypox, California Medical Association.
- Information for veterinarians, CDC.
- Monkeypox updates about clinical diagnosis and treatment, CDC.
